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To prevent cow’s milk Allergy: Introduce it in first two weeks of life

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“Breast milk should still be considered the nutritional staple of the infant, but health organizations should consider how to incorporate these findings into their future recommendations.”

Many doctors suggest that whole cow’s milk be avoided in the early months of an infant’s feeding. Lactation specialists go even further, counseling “mother’s milk only” until baby starts eating solid food.

But new research from Tel Aviv University says that mothers who feed their babies cow’s milk in the first 15 days of life may be protecting their children from dangerous allergies later on.

Yitzhak Katz, MD, and colleagues in the Pediatrics Department at TAU’s Sackler School of Medicine have found that babies who are fed cow milk protein early, in the form of infant formula, seem to be protected from developing an allergy to the same protein later in life.

In the longest and largest prospective study of its kind, the researchers tracked the feeding history of 13,019 infants. Based on these histories, physical examinations, testing, and challenging, they report:

“Women who regularly (daily) introduced their babies to cow milk protein early, before 15 days of life, almost completely eliminated the incidence of allergy to cow milk protein in their babies.”

Their findings are published in the July issue of Journal of Allergy and Clinical Immunology. (See “Early exposure to cow’s milk protein is protective against IgE-mediated cow’s milk protein allergy.”)

The Crucial First 15 Days

Children who were started on infant formula containing cow’s milk protein in the first through the 15th days of life were almost completely protected from developing Cows Milk Protein Allergy (CMA) – 19 times more protected than babies fed cow’s milk protein after 15 days.

CMA can be dangerous to babies, leading to rashes, respiratory problems, shock and even death, so this boost to the immune system early in life acts as a “vaccination.”

The surprising results from the study emerged when Prof. Katz and his colleagues set out to find if CMA was accompanied by an allergy to soy milk as well.

“We weren’t even looking for a risk factor,” he says, adding that they found no link between cow’s milk and soy allergies, despite previous evidence that had proposed a link. “Soy is still a reasonable feeding alternative for children with cow’s milk allergy,” Dr. Katz says.

At this point, he can’t say how much formula is needed to produce the protective effect, but the pediatrician suggests a single bottle-feed at night for those mothers who are breastfeeding. More conclusive studies will be needed to provide a definite recipe.

Counseling the World Health Organization

The Tel Aviv University study provides invaluable information for lactation specialists, and possibly for the World Health Organization, which currently recommends that a woman switch from breast to bottle at the three-to-five month period.

It is exactly this age period (three to five months) that Dr. Katz found to be the worst time to expose a baby to cow’s milk.

If not exposed earlier, he suggests waiting until the child is one year old to introduce cow’s milk into the diet.

The study also provides the most conclusive results to date on the incidence of allergy to cow’s milk protein in babies and children.

In a given population, the rates of allergy are still quite high – 0.5% (half a percent) in Dr. Katz’s estimation – but much lower than the 2% to 4% documented in other literature.

More research is needed on how early feeding of cow’s milk may protect a child from the common cow’s milk allergy into his/her teen and adult years.

Meanwhile, Dr. Katz suggests a feed of high-quality formula every night after birth – giving Dad an opportunity to enjoy some quality time with baby as well, he points out.

Source: Based on American Friends of Tel Aviv University press release, July 14, 2010

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